Of the more than 125 articles we posted in 2014, below are eight of the most read and most discussed articles on blood clots (order is by publication date):
The Physician-Patient Alliance for Health & Safety, the Institute for Healthcare Improvement and the National Perinatal Association are pleased to announce the release of safety recommendations targeting the prevention of venous thromboembolism (VTE) in maternal patients.
Maternal death rate in the USA has more than doubled in the last 25 years and data from the Centers for Disease Control and Prevention (CDC) show that pregnancy-related mortality is rising in the United States:
- Managing Risk and Reducing Readmissions: New Safety Recommendations Prevent Venous Thromboembolism in Maternal Patients (January 2014)
The importance of the OB VTE Safety Recommendations:
Patients undergoing general surgery overall are at high risk to develop DVT. It has been reported that the cost associated with a thromboembolic event averages $10,804 for a DVT and $16,644 for a pulmonary embolism (PE). The CDC includes reduction in DVT as one of ten major factors for reducing adverse events.
- “No patients are low risk” when it comes to cesarean delivery and venous thromboembolism (February 4, 2014)
According to Peter Cherouny, MD, Emeritus Professor, Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont, Chair and Lead Faculty of the IHI Perinatal Improvement Community:
“Essentially every patient is at moderate risk. The only exceptions to that would be patients who have surgery less than 30 minutes who are under 40 who have no other risk factors. I would make the argument that no patients are low risk.”
As Dr. Cherouny explains, even though some cesarean surgeries are performed in less than 30 minutes, the VTE risk clock starts during induction of anesthesia.
“If you take that into account,” Dr. Cherouny says, “there is really no case of a patient in the low risk category undergoing a cesarean section.”
- Put the “M” Back in Maternal-Fetal Medicine: Implementing VTE Prevention Guidelines (February 19, 2014)
Every physician knows that venous thromboembolism (VTE) kills. Often, the
re are symptoms, such as pain and swelling in the leg or a severe headache. If a patient communicates these symptoms to you, there is a good chance that if a VTE is responsible it can be identified and managed. But sometimes, VTE is sudden and has catastrophic results, as it did with Amee VanTassell, pictured left with her father. She died from a blood clot 4 days after delivering her daughter via cesarean section at the age of 36.
Other patients, such as Amber Scott, are luckier. Amber, now age 30 (pictured right with her daughter), 
fell into a coma because of a blood clot that developed in her brain. While in a coma, a cesarean section was performed, and Amber was delivered of a healthy baby girl. More than a year later, Amber’s recovery from the blood clot that nearly claimed her life continues with daily outpatient rehabilitation sessions.
The good news is that new guidelines for VTE prevention in pregnancy have been released, and incorporating them into your clinical practice should result in minimizing the number of cases of VTE in pregnant patients admitted for delivery or other procedures.
- Mother Dies After Childbirth – What you need to know about Amniotic Fluid Embolism Now (May 1, 2014)
An amniotic fluid embolism is a rare but serious condition that occurs when amniotic fluid — the fluid that surrounds a baby in the uterus during pregnancy — or fetal material, such as hair, enters the maternal bloodstream.
- Preventing Blood Clots in Stroke Patients: An Interview with Dr. Martin Dennis on the Clots 3 Study (August 2014)
Venous thromboembolism (VTE) is a common and potentially avoidable cause of death and illness in hospitalized patients. Each year in the United States, it has been estimated that about 300,000 cases of VTE occur. Mortality can be as high as 3.8 percent in patients with deep vein thrombosis (DVT) and 38.9 percent in those with pulmonary embolism (PE). VTE is associated with a high risk of death in the United States and Europe, with an estimated incidence rate of one in 1,000 patients. VTE is particularly common after a stroke. Approximately 20 percent of hospitalized immobile stroke patient will develop DVT and 10 percent a PE.
The Clots 3 study led by Martin Dennis, MD of University of Edinburgh, Western General Hospital may change the clinical practice to prevent DVT in stroke patients.
- Take the Challenge Out of Managing the Complex Obstetric Patient (June 10, 2014)
In this case study, a case study is discussed of a unique, complex, obstetrical patient who was morbidly obese (BMI > 67) and who underwent a cesarean delivery with anesthesia, and had other complex medical issues.
This patient was significantly helped by guidance from the recently released OB VTE Safety Recommendations, which offer a defined clinical process that covers the entire continuum of care.